Provider Demographics
NPI:1447819339
Name:HOPSON, CHRISTINA MARY
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARY
Last Name:HOPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 LEE ST
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55309-8602
Mailing Address - Country:US
Mailing Address - Phone:763-843-7369
Mailing Address - Fax:
Practice Address - Street 1:500 W MAIN ST STE 11
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2000
Practice Address - Country:US
Practice Address - Phone:763-753-8658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN236179-2163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health